Grace S. Kim, MD

All Publications

• The safety and efficacy of radiofrequency ablation in benign pediatric thyroid disease in the US: An initial case series. Laryngoscope investigative otolaryngology Kim, G. S., Seeley, H., Noel, J., Ahmad, I., Meister, K. 2024; 9 (1): e1198

  Abstract

  To evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign nonfunctional thyroid nodules or functional lingual thyroid gland in a pediatric population.Four pediatric patients (four female; mean age 13.50 ± 4.04, range 8-17 years) with either benign thyroid nodules or mildly obstructive lingual thyroid glands were treated with RFA from 2020 to 2021 were evaluated. The inclusion criteria for RFA therapy were (i) age < 18 years; (ii) benign cytopathological results on ultrasound guided fine needle aspiration; (iii) pressure or pain symptoms caused by the thyroid nodules; (iv) dysphagia or obstruction caused by the lingual thyroid tissue; (v) follow up for >6 months with otolaryngology or endocrinology.Two patients had benign non-functioning thyroid nodules and two had mildly obstructive functioning lingual thyroid glands. Mean follow up was 10.75 ± 4.79 months. Each patient underwent one RFA session with no complications. For the patients with thyroid nodules, there was >74% reduction in nodule size at last follow up with improvement in neck swelling and pain. For the patients with lingual thyroid glands, both did not have any other functional thyroid gland identified. Both had visible decrease in size of the gland as visualized transorally with improvement in dysphagia and obstructive symptoms when lying flat.RFA is a safe and effective option for managing benign thyroid nodules and lingual thyroid glands in a pediatric patient population.4.

  View details for DOI 10.1002/lio2.1198

  View details for PubMedID 38362180

  View details for PubMedCentralID PMC10866600

• Esophageal lung, pulmonary artery sling and congenital tracheal stenosis: A case report JOURNAL OF PEDIATRIC SURGERY CASE REPORTS Liang, N. E., Kim, G. S., Gugig, R., Ma, M., Coll, A., Sidell, D., Bruzoni, M. 2024; 101

  View details for DOI 10.1016/j.epsc.2023.102772

  View details for Web of Science ID 001154609300001

• Promoting Surgeon-Scientists in Otolaryngology-Head and Neck Surgery-From Bench to Bedside. JAMA otolaryngology-- head & neck surgery Kosaraju, N., Keating, D. P., Kim, G. S., Moore, L. S., Stankovic, K. M. 2023

  Abstract

  Surgeon-scientists (defined as principal investigators [PIs] with a Doctor of Medicine [MD] degree or a combined MD and Doctor of Philosophy [PhD] degree) in otolaryngology-head and neck surgery (OHNS) are imperative for achieving clinical translation in the OHNS field.To (1) raise awareness about the current state of surgeon-scientists in OHNS, (2) contextualize the landscape of surgeon-scientists in OHNS by comparing it to those of neurosurgery and ophthalmology, and (3) identify strategies for attracting and retaining surgeon-scientists in OHNS.Research funding data from fiscal years 2015 to 2021 among surgeon-scientists in OHNS, neurosurgery, and ophthalmology were obtained from the National Institutes of Health (NIH) Research Portfolio Online Reporting Tools Expenditures and Results and the US Department of Defense (DOD) Congressionally Directed Medical Research Programs awards database. The Association of American Medical Colleges provided the total number of active physicians in each specialty per year and the number and percentage of residents with an MD-PhD degree in each specialty per year. Cohen d was used to express the standardized value of the magnitude of the mean difference between compared groups.From 2015 to 2021, on average, there were 9566 active physicians in OHNS, 5559.8 in neurosurgery, and 18908.8 in ophthalmology. In OHNS, a greater number of NIH K (research career development) grants were held by surgeon-scientists than by PIs with a PhD degree (21.4 vs 5.1; mean difference, 16.3; 95% CI, 14.3-18.3; Cohen d = 9.6), whereas most NIH R (research) and U (cooperative agreement) grants (144.1 vs 81.6; mean difference, 62.6; 95% CI, 46.3-78.9; Cohen d = 4.5) and DOD grants (9.9 vs 4.1; mean difference, 5.7; 95% CI, 1.0-10.4; Cohen d = 1.4) were held by PIs with a PhD degree. In a comparison of OHNS to neurosurgery and ophthalmology, after the number of R and U grants was scaled by the number of physicians in each field, neurosurgery had a much greater number of grants per surgeon than OHNS (0.02 vs 0.01; mean difference, 0.01; 95% CI, 0.01-0.02; Cohen d = 4.2). Additionally, neurosurgeons received a much larger R and U grant amount per physician than otolaryngologists ($10 630.20 vs $4511.80; mean difference, $6118.40; 95% CI, $2625.90-$9610.80; Cohen d = 2.0). For the R and U grant metrics, there were no meaningful differences between OHNS and ophthalmology.Results of this database study showed that from 2015 to 2021, the number of governmental grants held by surgeon-scientists in OHNS increased, but there is room for improvement given the metrics of neurosurgeons, a population smaller than otolaryngologists. Possible strategies include intramural research grants, surgeon-scientist training programs, and partnerships between specialty societies and NIH administering institutes and centers.

  View details for DOI 10.1001/jamaoto.2023.3353

  View details for PubMedID 37856105

• Repair of surviving hair cells in the damaged mouse utricle. Proceedings of the National Academy of Sciences of the United States of America Kim, G. S., Wang, T., Sayyid, Z. N., Fuhriman, J., Jones, S. M., Cheng, A. G. 2022; 119 (15): e2116973119

  Abstract

  SignificanceThe mammalian utricle shows limited hair cell regeneration despite partial recovery of function. Recovery of vestibular evoked potentials, a measure of utricular function, occurs after utricular hair cell damage in mammals. While previous work has shown limited regeneration in response to damage, most regenerating hair cells are type II with immature-appearing bundles. Whether hair cells that remain ("surviving hair cells") can self-repair and contribute to functional recovery is unknown. Using lineage tracing, we have characterized surviving hair cells over time and found that they repair bundles, regain innervation, and remain differentiated, and are therefore poised to contribute to the recovery of organ function.

  View details for DOI 10.1073/pnas.2116973119

  View details for PubMedID 35380897

• Middle Cranial Fossa Approach to Repair Tegmen Dehiscence Using Self-setting Calcium Phosphate Cement: A Retrospective Case Review. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Bulsara, V. M., Kim, G. S., Fouad, A. M., Bulsara, M. K., Santa Maria, P. L. 2021

  Abstract

  OBJECTIVES: To review the outcomes of repairing tegmen dehiscence using the middle cranial fossa approach with a self-setting bone cement.STUDY DESIGN: Retrospective case series.SETTING: Two academic tertiary hospitals.PATIENTS: All patients presenting for surgical repair of tegmen dehiscence and with postoperative follow-up for at least 6 months between October 2015 and July 2019.INTERVENTION: Surgical repair using a middle cranial fossa approach using a layered reconstruction with temporalis fascia and self-setting calcium phosphate bone cement.MAIN OUTCOME MEASURES: Perioperative complications, recurrence of presenting symptoms/disease, hearing, and facial nerve grade.RESULTS: The cohort consisted of 22 patients with 23 tegmen dehiscence repairs (1 sequential bilateral repair). There were 16 males and 6 females with an average age at operation of 52.6 years. Repairs were left sided in 9, right sided in 12 patients, and bilateral in 1 patient. No patients had recurrence of presenting symptoms or disease at most recent follow-up. Preoperative hearing was maintained in all patients. Two patients (9% of repairs) experienced delayed partial temporary facial nerve weakness House-Brackman grade 2 and 4 which had recovered by 8 weeks postoperative.CONCLUSION: We demonstrate a technique for repairing tegmen dehiscence of the middle cranial fossa floor that has excellent postoperative outcomes. We highlight potential technical challenges in this approach as well as the need for counseling for potential partial transient facial nerve dysfunction.

  View details for DOI 10.1097/MAO.0000000000003110

  View details for PubMedID 33710151

• Major complications after tongue-tie release: A case report and systematic review. International journal of pediatric otorhinolaryngology Solis-Pazmino, P., Kim, G. S., Lincango-Naranjo, E., Prokop, L., Ponce, O. J., Truong, M. T. 2020; 138: 110356

  Abstract

  INTRODUCTION: The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest increase has been in neonates. For parents considering frenotomy for their breastfeeding newborn, there is controversy surrounding the evaluation of tongue-tie and the benefit of a frenotomy. Complications from tongue-tie procedures are thought to be low, though it is not well reported nor studied.OBJECTIVES: The aim of this study is to describe a case of a sublingual mucocele after laser frenotomy in a neonate with tongue-tie and to investigate major complications reported after tongue-tie release in pediatric patients through a systematic review of the literature.CASE REPORT: We present a 6-week-old female who underwent a laser frenotomy procedure performed by a dentist who presented with a new cyst under her tongue.MATERIAL AND METHODS: A systematic literature search of articles published from 1965 to April 2020 was conducted in Ovid MEDLINE(R), Ovid EMBASE, and Scopus. Citations were uploaded into a systematic review software program (DistillerSR, Ottawa, ON, Canada), followed by full text screening.RESULTS: 47 major complications were reported in 34 patients, including our patient. Most of the cases were located in the United States and Europe. The most frequent indications for the procedure were breastfeeding problems (n=18) and speech impediment (n=4). The procedure was performed by dentists (n=6), lactation consultants (n=5), and otolaryngologists (n=4). The bulk of the major complications after frenotomy included poor feeding (n=7), hypovolemic shock (n=4), apnea (n=4), acute airway obstruction (n=4), and Ludwig angina (n=2).CONCLUSIONS: Reporting of complications after frenotomy is lacking. Risks to neonates may be different than risks to older children and adults. Practitioners across different specialties should be monitoring and studying this more rigorously to better guide patients and families on the risks and benefits of this procedure.

  View details for DOI 10.1016/j.ijporl.2020.110356

  View details for PubMedID 32927351

• Advances in Inner Ear Therapeutics for Hearing Loss in Children CURRENT OTORHINOLARYNGOLOGY REPORTS Aaron, K. A., Kim, G. S., Cheng, A. G. 2020; 8 (3): 285-294

  View details for DOI 10.1007/s40136-020-00300-y

  View details for Web of Science ID 000702480100011

• Congenital Orocutaneous Fistula Associated With Ectopic Salivary Glands and Submandibular Gland Aplasia. The Laryngoscope Trieu, V., Hosseini, D. K., Kim, G. S., Truong, M. T., Cheng, A. G. 2020

  View details for DOI 10.1002/lary.28921

  View details for PubMedID 33059385

• Prevalence and significance of cranial nerve imaging abnormalities in patients with hereditary neuropathies: Clinical implications at the skull base. Laryngoscope investigative otolaryngology Bartholomew, R. A., Zamani, A. A., Kim, G. S., Alyono, J. C., Steinert, H., Fridman, V., Sadjadi, R., Jackler, R. K., Corrales, C. E. 2020; 5 (1): 11-18

  Abstract

  To estimate the prevalence and significance of cranial nerve (CN) imaging abnormalities in patients with hereditary neuropathy and discuss clinical implications.We retrospectively analyzed data from patients at four tertiary academic medical centers with hereditary neuropathy diagnoses who had undergone gadolinium-enhanced magnetic resonance imaging (MRI) of the brain or skull base between 2004 and 2018. MRI scans, as well as computed tomography imaging when available, were reviewed and bivariable analysis was performed to identify predictors of CN abnormalities on imaging.Among 39 patients meeting study criteria, 11 had clinical CN deficits (28%) and 8 had CN abnormalities on imaging (21%). Of the patients with CN abnormalities on imaging, half had CN deficits (4/8) and only a quarter had imaging abnormalities of the CNs with the deficits (2/8). Imaging abnormalities were found in varied CNs, including CNs III, V, VII, and the VII/VIII complex in the internal auditory canal. MRI obtained for the purpose of evaluating CN deficits had a statistically significant increased likelihood of containing CN imaging abnormalities. However, CN deficits themselves were not predictive of imaging abnormalities.Thickening and enhancement of CNs on MRI may be found in approximately 1/5 of patients with hereditary neuropathies and are inconsistently associated with clinical deficits. These imaging findings should not be mistaken for neoplastic and infectious processes as they may be manifestations of the patients' underlying genetic neuropathy.4.

  View details for DOI 10.1002/lio2.343

  View details for PubMedID 32128425

  View details for PubMedCentralID PMC7042653

• Direct cellular reprogramming and inner ear regeneration EXPERT OPINION ON BIOLOGICAL THERAPY Atkinson, P. J., Kim, G. S., Cheng, A. G. 2019; 19 (2): 129–39

  View details for DOI 10.1080/14712598.2019.1564035

  View details for Web of Science ID 000457600200006

• Molecular therapy for genetic and degenerative vestibular disorders. Current opinion in otolaryngology & head and neck surgery Sayyid, Z. N., Kim, G. S., Cheng, A. G. 2018

  Abstract

  PURPOSE OF REVIEW: The primary purpose of this review is to summarize current literature in the field of vestibular regeneration with a focus on recent developments in molecular and gene therapies.RECENT FINDINGS: Since the discovery of limited vestibular hair cell regeneration in mammals in the 1990s, many elegant studies have improved our knowledge of mechanisms of development and regeneration of the vestibular system. A better understanding of the developmental pathways of the vestibular organs has fueled various biological strategies to enhance regeneration, including novel techniques in deriving vestibular hair cells from embryonic and induced pluripotent stem cells. In addition, the identification of specific genetic mutations responsible for vestibular disorders has opened various opportunities for gene replacement therapy.SUMMARY: Vestibular dysfunction is a significant clinical problem with limited therapeutic options, warranting research on biological strategies to repair/regenerate the vestibular organs to restore function. The use of gene therapy appears promising in animal models of vestibular dysfunction.

  View details for DOI 10.1097/MOO.0000000000000477

  View details for PubMedID 30045104

• Outcomes of chronic frontal sinusitis treated with ethmoidectomy: a prospective study INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY Abuzeid, W. M., Mace, J. C., Costa, M. L., Rudmik, L., Soler, Z. M., Kim, G. S., Smith, T. L., Hwang, P. H. 2016; 6 (6): 597-604

  Abstract

  In medically refractory chronic frontal sinusitis, ethmoidectomy without instrumentation of the frontal ostium may resolve frontal disease. Our aim was to determine the efficacy of ethmoidectomy alone for the treatment of chronic frontal sinusitis.Adults with chronic rhinosinusitis prospectively enrolled in a multicenter study who demonstrated frontal sinusitis on computed tomography were divided into 2 groups: (1) endoscopic sinus surgery (ESS) incorporating ethmoidectomy, but excluding frontal sinusotomy; and (2) ESS incorporating frontal sinusotomy. The primary outcome was improvement in 22-item Sino-Nasal Outcome Test (SNOT-22) scores. Secondary outcomes included endoscopic scores and use of corticosteroids and antibiotics.A total of 196 cases undergoing frontal sinusotomy and 30 cases treated with ethmoidectomy without frontal sinusotomy were analyzed and were comparable demographically. The prevalence of nasal polyps, previous ESS, asthma, and aspirin intolerance was more common in the frontal sinusotomy group (p < 0.050). Preoperative endoscopy and computed tomography scores were higher in the frontal sinusotomy group (p ≤ 0.001). Postoperatively, both groups showed comparable SNOT-22 scores with worse endoscopy scores in the frontal sinusotomy group (p = 0.038). Postoperative improvement in SNOT-22 total and subdomain scores was comparable between groups. Nasal endoscopy scores improved to a greater degree in the frontal sinusotomy group (p = 0.023). Duration of postoperative topical steroid use was higher in the frontal sinusotomy group (p = 0.007). Revision surgery was needed in 2.6% of frontal sinusotomy patients and 0% of patients without frontal sinusotomy.The treatment of chronic frontal sinusitis through ethmoidectomy is a potential alternative to frontal sinusotomy achieving similar quality of life (QOL) improvements in patients manifesting less severe sinus disease.

  View details for DOI 10.1002/alr.21726

  View details for PubMedID 26879467

• Lgr5+ cells regenerate hair cells via proliferation and direct transdifferentiation in damaged neonatal mouse utricle. Nature communications Wang, T., Chai, R., Kim, G. S., Pham, N., Jansson, L., Nguyen, D., Kuo, B., May, L. A., Zuo, J., Cunningham, L. L., Cheng, A. G. 2015; 6: 6613-?

  Abstract

  Recruitment of endogenous progenitors is critical during tissue repair. The inner ear utricle requires mechanosensory hair cells (HCs) to detect linear acceleration. After damage, non-mammalian utricles regenerate HCs via both proliferation and direct transdifferentiation. In adult mammals, limited transdifferentiation from unidentified progenitors occurs to regenerate extrastriolar Type II HCs. Here we show that HC damage in neonatal mouse utricle activates the Wnt target gene Lgr5 in striolar supporting cells. Lineage tracing and time-lapse microscopy reveal that Lgr5+ cells transdifferentiate into HC-like cells in vitro. In contrast to adults, HC ablation in neonatal utricles in vivo recruits Lgr5+ cells to regenerate striolar HCs through mitotic and transdifferentiation pathways. Both Type I and II HCs are regenerated, and regenerated HCs display stereocilia and synapses. Lastly, stabilized ß-catenin in Lgr5+ cells enhances mitotic activity and HC regeneration. Thus Lgr5 marks Wnt-regulated, damage-activated HC progenitors and may help uncover factors driving mammalian HC regeneration.

  View details for DOI 10.1038/ncomms7613

  View details for PubMedID 25849379

• Making sense of Wnt signaling-linking hair cell regeneration to development. Frontiers in cellular neuroscience Jansson, L., Kim, G. S., Cheng, A. G. 2015; 9: 66-?

  Abstract

  Wnt signaling is a highly conserved pathway crucial for development and homeostasis of multicellular organisms. Secreted Wnt ligands bind Frizzled receptors to regulate diverse processes such as axis patterning, cell division, and cell fate specification. They also serve to govern self-renewal of somatic stem cells in several adult tissues. The complexity of the pathway can be attributed to the myriad of Wnt and Frizzled combinations as well as its diverse context-dependent functions. In the developing mouse inner ear, Wnt signaling plays diverse roles, including specification of the otic placode and patterning of the otic vesicle. At later stages, its activity governs sensory hair cell specification, cell cycle regulation, and hair cell orientation. In regenerating sensory organs from non-mammalian species, Wnt signaling can also regulate the extent of proliferative hair cell regeneration. This review describes the current knowledge of the roles of Wnt signaling and Wnt-responsive cells in hair cell development and regeneration. We also discuss possible future directions and the potential application and limitation of Wnt signaling in augmenting hair cell regeneration.

  View details for DOI 10.3389/fncel.2015.00066

  View details for PubMedID 25814927